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Ophthalmic Images
October 8, 2015

Burrow in the SphenoidA Clue to Occult Pulmonary Tuberculosis

Author Affiliations
  • 1Ophthalmic Plastics, Orbit and Ocular Oncology Services, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
JAMA Ophthalmol. 2015;133(10):e151498. doi:10.1001/jamaophthalmol.2015.1498

An otherwise healthy man in his early 20s presented with a chronic, intermittently discharging, nonhealing sinus over the left upper eyelid of about 3 months’ duration (Figure). There were no other associated visual or systemic concerns. History of a left upper eyelid abscess, incised and drained elsewhere, was elicited. Previous medical records were not available. Computed tomography imaging was suggestive of chronic osteomyelitis. Systemic investigation revealed multiple lung parenchymal infiltrates on chest radiography and isolation of acid-fast bacilli from the sputum. A diagnosis of pulmonary tuberculosis was thus established.13 Standard antitubercular treatment with first-line drugs was instituted and the sinus discharge resolved completely while receiving treatment.

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